Inspection on 08/05/06 for 10 Tanners Walk

This inspection was carried out on 8th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

10 Tanners Walk 25/11/05

10 Tanners Walk 29/06/05

10 Tanners Walk 27/01/05

10 Tanners Walk 10/06/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 10 Tanners Walk Off Newton Rd Twerton Bath Bath & N E Somerset BA2 1RG Lead Inspector David Smith Key Unannounced Inspection 8 and 10th May 2006 09:45 th 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 10 Tanners Walk Address Off Newton Rd Twerton Bath Bath & N E Somerset BA2 1RG 01225 331192 01225 331192 robin.carr@new-era.org.uk None Dimensions (UK) Ltd Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Robin Carr Care Home 5 Category(ies) of Learning disability (5), Physical disability (5) registration, with number of places 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 5 persons aged 18 years and over with physical and learning disabilities for respite care. 25th November 2005 Date of last inspection Brief Description of the Service: Tanners Walk provides respite care for up to five people who have a learning difficulty and/or physical disability. It is operated by Dimensions (UK) Ltd, which is a voluntary organisation. The home is a purpose built, split level building located in Twerton, two miles from the centre of Bath. Accommodation is modern and the home is accessible to those using wheelchairs. The home consists of two floors, an upper entrance level and a lower ground floor. The upper floor has three single bedrooms, with a further two bedrooms in the lower ground floor. There is a communal lounge area, a kitchen/dining room and a laundry area on the upper floor and a communal lounge/activity room with a small kitchen on the lower ground floor. Parking is available to the front of the Home. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection carried out over two days. The inspector gathered evidence for this report through discussions with the registered manager, deputy manager, care staff and one person who uses the service. Care plans and associated records were examined, together with staff personnel records, risk assessments and health and safety records. The inspector was also provided with a tour of the home. The people who use Tanners Walk wish to be described as “people who use the service”, or “individuals”, rather than service users. Dimensions (UK) Ltd uses the term “people we support”. This terminology has therefore been acknowledged and replaced the term “service user” in this report. It is noted the e-mail address should be amended to read robin.carr@dimensions-uk.org. This will be amended in the next inspection report. What the service does well: Tanners Walk provides a valuable respite care service for adults with a learning/physical disability in a supportive, caring and safe environment. One individual spoken with spoke very highly of the home and its staff team. The home promotes a person centred approach and remains committed to improving the service it provides wherever possible. Relevant information about each person who uses the service continues to be collected systematically and is well kept. The service works actively with external agencies and Health Care Professionals to develop and improve the support provided to people who use the service. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 6 There is a strong core of committed staff who are focussed on their responsibilities. Staff are well supported by a manager who is dedicated and able. Staff are responsive to the needs of each individual. What has improved since the last inspection? What they could do better: Fire safety training must now be provided by an accredited trainer. Each member of staff must also be provided with manual handling update training. Training in relation to responses to challenging behaviour should also be considered. This will ensure all staff are suitably trained to support individuals in a safe and consistent manner. All risk assessments must be regularly reviewed and updated in accordance with the home’s policy. This will help to ensure the safety of people who use the service and staff members. The carpets in bedrooms and communal areas must either be professionally cleaned or replacement considered. This will help to ensure a more homely environment for each person who uses the service. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 7 The organisation/home is required to keep the Commission for Social Care Inspection updated on progress with rectifying the subsidence problem. It is recommended that the refurbishment of the kitchen be considered once the subsidence problem is resolved. The home should endeavour to develop its progress in adapting information into accessible formats for people who use the service. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. The quality in this outcome area is good. There is a thorough and tailored process of information sharing, assessment and visiting which enables the home and each prospective user of the service and their families to make informed decisions regarding suitability of the service. Each individual has now been provided with an updated guide to the service. EVIDENCE: The home provides a respite service to approximately 25 - 30 adults with a range of learning and physical disabilities. Care plans examined showed that full assessments of the needs of those using the service are undertaken. The service provided at Tanners Walk remains contracted out to Bath and North East Somerset Council with the Community Learning Disabilities Team making referrals to the home. The home’s senior staff have regular meetings with Social Services professionals and new referrals are discussed as part of the agendas of these meetings. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 10 The manager told the inspector that Tanners Walk will be linking up with Beaumonds, a service which offers respite care to children. It is hoped this can provide a valuable link to people who may wish to use Tanners Walk when they become adults. The home offers introductory visits to those who may wish to use the service. One individual spoken with told the inspector she had visited the home before deciding to use the service. The home has a comprehensive Statement of Purpose. This is supplemented with the service users guide entitled “ A guide to staying at Tanners Walk 2006/2007”. Each individual has now been provided with this updated guide. This provides information on the services provided, help and support, charges, house rules and how to complain. It effectively provides an easy to read agreement between each individual and the home. The guides examined had been signed by each individual who uses the service or their parent/carer and the home manager. This is good practice. Emergency admissions can be catered for, though it was emphasised that these are not encouraged. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10. The quality in this outcome area is adequate. The care plans examined provided good information in how to support each individual, which are reviewed regularly. All information is confidential and stored securely. The home has an experienced and skilled staff team who provide appropriate levels of support to people who use the service. Staff also advocate appropriately for individuals. There are Risk Assessments in place. These must be reviewed on a regular basis and form part of each care plan to promote the safety of each person who uses the service. EVIDENCE: Five care plans were examined and these provided comprehensive information on the areas of support each person required. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 12 These records are now contained in two separate files. The ‘Care Plan’ contains assessments, individual’s history, archived information etc. Each person also now has ‘Support Guidelines’ which contain the information staff would need to provide the appropriate care and support for each individual when they use the service. Some support guidelines had either been personalised by the individual or had picture symbols added to the text. This was to encourage/support accessibility of these plans. Although further development may be a longer-term goal due to the diversity and number of people using the service, these efforts by the home are commended and the progress in this area will be focused upon as part of the next inspection process. Regular reviews are held, which include service users, their families, Social Workers and Keyworkers. The home reviews each care plan internally as well as attending these multi agency reviews, often in partnership with day services. These are clearly recorded and the outcomes used to update individual care plans. Interactions between staff and individuals who use the service were observed where possible during the inspection. One individual also spoke to the inspector privately. Both demonstrated the staff had a good knowledge of the support needs of each individual and how to communicate and guide them effectively. Discussion between the inspector and four staff members also confirmed this. There are person centred Risk Assessments in place, which are clear and concise. These support each person to take risks as part of an independent lifestyle. However, the inspector found some of these to be slightly out of date as there was no evidence of them being recently reviewed. All Risk Assessments must be subject to regular review to ensure the welfare of service users. Each individual’s records are well looked after, being kept securely in the main office. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. The quality in this outcome area is good. Individuals continue to attend their normal day care services and stays remain structured around these services. Staff at Tanners Walk continue to work hard to enable individuals to enjoy their leisure time. Staff both enable and support family contact. The views of family members have been acknowledged and accommodated where practicable. A healthy, balanced and varied diet is promoted. EVIDENCE: Most of the people who have regular respite stays have day care services organised that continue while they are in the home. There remains a close 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 14 relationship and ongoing communication between the home and each individual’s day service. It was evident from records, discussions with staff and from the observations of the interactions between staff and people using the service that each individual continues to be given opportunities and encouragement to develop personally during their stays in the home. Staff spoken with explained that they work hard to ensure each person is provided with opportunities to do things which they enjoy. Each person is seen as an individual and is respected as such. One individual who spoke with the inspector explained that she enjoys cooking, film, drama and horse riding whilst at day services. During her stays at Tanners Walk she enjoys “doing her own thing”, going to the pub, listening to music, drawing and helping with the cooking. She told the inspector she liked all of the staff, they made her “very happy and welcome” and “made her feel warm”. People who use the service were seen to access all areas of the home with confidence and to be treated with dignity and respect by all staff. Each individual’s file showed that the home has a good liaison with family members with regular communication with parents and carers taking place. Staff spoken with feel they provide a valuable service for parents/carers. They often are asked for and provide advice to them, as well as providing respite care for their relatives. The menus show a wide range of food, which provide both a healthy and balanced diet. Each person is given a choice of what they would like to eat. One individual spoken with told the inspector the food was “really nice. I like the cooking here”. She was encouraged by staff to help as much as she could with the cooking. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. The quality in this outcome area is good. The care plans clearly explain the support each individual requires in relation to their personal and health care. Experienced staff have a good knowledge of each individual’s needs and how to provide appropriate levels of support. An effective system of medication administration is in operation and this is well managed. EVIDENCE: The care documentation in place for individuals provided clear guidance for staff on how they should support each individual with their personal care. Each person had in place care plan information covering the holistic and varied needs of individuals. People who use Tanners Walk retain their own General Practitioner; GPs are requested to visit the Home if needs be though in most situations, a person’s 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 16 relative or carer would be asked to take that person to the GPs surgery if this was necessary during their stay. Other specialist services are contacted when an identified need arises. These are provided by Bridges Community Learning Disability Team. It was explained to the inspector that the home has a good working relationship with Bridges CLDT. Staff feel they provide a valuable resource to assist the home in providing a specialist service for a large number of individuals with diverse needs. It was evident at this inspection that the management and staff spoken with are sensitive to the personal/healthcare and emotional needs of those using the service. The home has an effective, efficient system of medication administration and storage. The deputy manager explained this system to the inspector in detail. Each individual has a medication profile. This details the current prescribed medication, dosage, times etc. The home ensures this is regularly updated by each person’s GP. The inspector was shown updates received in the post that day from GPs, which confirmed this process works well. Each person who uses the service will come in with his or her medication. Generally the medication will only be sufficient to cover the length of their stay, although occasionally extra medication may be provided. This is checked and booked in when the person arrives. Two staff are required for this process who both sign the relevant records. The medication is stored securely in the medication cabinet, which is in the main office. When medication is dispensed by staff, two staff members sign the records. When the respite stay comes to an end, the medication records are again checked and any extra medication is booked out and returned to the individual concerned. Again, two staff are required for this process and both sign the records. The home conducts annual in-house medication assessments for all staff. The inspector was told this will shortly be supplemented by ‘Protocol Training’ in the administration of medication. This course is in the style of an NVQ unit and is accredited by the City of Bath College. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The quality in this outcome area is good. Each individual is enabled to communicate their views and they can be confident that they will be listened to and their views acted on if necessary. Clear policies and procedures are in place in order to protect individuals who use the service from the likelihood of abuse, neglect and self-harm. EVIDENCE: The guide provided to each person who uses the service explains how to make a complaint. This process is described as ‘Making a complaint or speaking out’. This is supplemented by the organisational policies and procedures. The home’s complaints log was examined. There has been one complaint from a relative since the last inspection. Through examination of the records and discussion with the manager, it was apparent that this issue had been taken seriously and acted upon in accordance with the home’s policy. One individual spoken with told the inspector she would tell staff if she had a problem or felt unhappy. She said the staff would “help me, sort it out for me. That’s the proper way.” She has not had any need to complain as she confirmed she was very happy during her stays at the home. Other individuals who use the service would also be able to advocate for themselves, raise issues with the staff or use the complaints procedure. Due to 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 18 the diverse abilities and needs of the people who use Tanners Walk, staff would need to advocate for a number of individuals. Staff spoken with were clear about the advocacy role they have. Due to the vulnerability of some of the people who use the service, they would rely on staff raising concerns on their behalf. Staff spoken with demonstrated a very good knowledge of the action they would take if they suspected or witnessed abuse. They also confirmed that they had received training in the Protection of Vulnerable Adults and were clear in their own views about providing a safe and supportive environment for each individual. They use their daily interactions and observations when supporting individuals to help alert them to any physical signs or changes in behaviour, which may cause them concern. It was noted by the inspector that the home had recently received two letters from families which were extremely complimentary regarding the service their relative had received and about the home and staff team more generally. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 29 and 30. The quality in this outcome area is adequate. The home is generally well maintained, however improvements are needed to maintain safety, comfort and provide a more homely environment for the service users. The home has adaptations, which complement both the skills and abilities of the people who use the service, and helps to promote their independence. The home was clean and tidy. EVIDENCE: There have been no changes in the services and facilities provided at the home since the previous inspection. The location and layout of the home is suitable for its intended purpose. The home is tastefully decorated and generally well maintained. Furniture and fittings are good. All rooms are clean and tidy including the bathrooms and toilets that are free of any odours. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 20 The upper level of the home is fully accessible to wheelchair users. There are three single bedrooms one of which is en-suite with an overhead track hoist and fully assisted bath. The other two bedrooms have washbasins. There are two other single bedrooms on the ground floor, also equipped with washbasins. There is a through floor lift to the ground floor, although wheelchair users generally use the bedroom located on the upper floor. The inspector viewed all of the bedrooms. Each room is decorated differently. Some individuals do have preferred rooms to occupy during their stay and these wishes are respected wherever possible. One individual spoken with said they liked the pink bedroom as this was their favourite colour. It was the same colour as their bedroom at home. They often chose this room during their stays at Tanners Walk. They also told the inspector they could bring in any personal items they wished to during their stay. This encourages/supports people to personalise their rooms. One bedroom has recently been refurbished. This has been redecorated and had laminate style lino flooring laid. This has greatly improved this area for individuals who choose this bedroom. The home’s carpets show signs of wear and some are stained. This is understandable given the nature of the service and the varied support needs of the people who use it. The home endeavours to ensure these are cleaned regularly, however professional cleaning should be considered. If this does not improve their appearance then they should be replaced. The subsidence of the home remains a problem. It is particularly affecting the kitchen area and large cracks were evident in the walls, tiles and ceiling. Cracks are also evident in the adjoining lounge wall. It does not appear to pose any immediate danger and actions to rectify the situation are in hand. An arborist has recently visited the home and his report is awaited. There are plans to refurbish the kitchen where work surfaces and some units are showing signs of wear as mentioned at the last two inspections. This refurbishment will occur once the subsidence issue is resolved. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36. The quality in this outcome area is adequate. There is a strong core of committed staff who are focussed on their responsibilities. Staff are well supported by the manager. The relationships between staff and people who use the service are well established. This provides a supportive environment for each individual. The home’s recruitment policy promotes both individual’s rights and their safety. Staff are generally provided with appropriate training and support to ensure they can meet each individual’s care and support needs. Fire safety and manual handling training must be provided to all staff. EVIDENCE: There is a core of well-established staff with varying skills and abilities who meet the needs of each individual who uses the service. Staff members spoken with had a clear understanding of their role and responsibilities within the team and their own personal role and accountability. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 22 Staff members spoken with told the inspector that the staff team was extremely open, honest and supportive. Each commented that it was a nice home to work in. They felt well supported by the manager and were able to discuss issues in an open and honest way. The home operates a robust recruitment policy. The personnel files examined show records of staff application forms, references, proof of identity, and enhanced Criminal Record Bureau Disclosures. These are all stored securely, being kept in locked filing cabinets and accessed only by the manager or his deputy. Staff are provided with a variety of training opportunities. Training is provided either by the organisation or external training providers. Staff spoken with told the inspector that they are provided with training to enable them to meet the needs of people using the service. Some issues regarding training remain. The issue of who is to provide fire safety training has now been resolved. This will now be delivered by an accredited external trainer, but is yet to be delivered to the staff team. The manual handling training has been organised but is still to be delivered to the team. The home also intends to provide additional makaton and challenging behaviour training. The requirements/recommendations regarding staff training are therefore repeated in this report with extended timescales to enable compliance. Each member of staff is provided with regular formal supervision. This is a 1:1 meeting with their supervisor. Staff spoken with felt this was valuable and they were able to have open and honest discussions with their line manager. Staff told the inspector they were supervised approximately every four to six weeks. The home also endeavours to annually appraise each employee. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 and 43. The quality in this outcome area is adequate. The home is well managed ensuring that individual’s interests and rights are promoted and protected. The manager is qualified and competent to run Tanners Walk, and meet its statement of purpose, aims & objectives. The manager promotes a person centred approach and this is clearly communicated throughout the service. There are systems in place designed to promote and protect the health & safety of both individuals and staff. Minor improvements are required to ensure the welfare and safety of individuals and staff. The progress made in providing information in formats accessible for people who use the service should be reviewed by the home. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 24 EVIDENCE: The manager has worked at Tanners Walk since 1991 and has been its Manager since 2000. Records show that he has a RNMH qualification, a City and Guilds 325.3 Advanced Management in Care Award, a NEBS Supervisory Management Qualification and that he continues to work towards his Registered Manager’s NVQ Level 4 and NVQ Assessor awards. He also undertakes periodic training to maintain his knowledge and update his skills and level of competence. The management approach, by both the manager and his deputy, is open and positive. This is a clear sense of direction and leadership. Staff spoken with praised the home’s management, said their views are listened to, and that they are well supported in their roles. The home continues to develop its person centred approach to the care and support of each individual. It is hoped that additional staff training and awareness of communication methods will help to develop better strategies and assist with adapting written information into more accessible formats for individuals. The outcomes of this development work will be focused upon as part of the next inspection process. The manager is keen to develop and improve the service where possible. For example he is attending a challenging behaviour workshop in June. He is also linking with Bridges CLDT to help develop the home’s strategies in responding to behaviour, which may be perceived as challenging. This will help to ensure a flexible and responsive service for individuals who may present such behaviours and provide staff with the necessary skills to support individuals. In general, the recording systems in place to support the maintenance of health and safety in the home are being used consistently. Staff members have delegated responsibilities in relation to monitoring health and safety within the home. The fire logbook for the home was examined at this inspection. Regular fire drills are taking place; the last recorded dates were 18/05/05 and 23/11/05. The alarm system, emergency lighting and fire extinguishers are serviced/checked annually. The fire alarm system should be checked on a weekly basis by staff. However, during the last sixteen weeks, there were minor gaps as there is no record of the fire alarm system being checked on two separate weeks. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 25 The home has a comprehensive Fire Risk Assessment, however this was found to be out of date on the first day of inspection as it was last reviewed in July 2004. This was reviewed/updated prior to the inspector returning to complete the inspection. The home maintains records relating to PAT testing, lift servicing, hoist servicing, sling safety checks, electrical wiring, water temperatures, fridge and freezer temperatures and safety of gas appliances. All of these records were in order and checks were up to date. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 2 3 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 27 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23(2)(b) Requirement Ensure CSCI is regularly updated on how the home’s subsidence is being addressed and rectified. Ensure appropriate fire safety training is provided for all staff. Ensure manual-handling training is provided to all staff. Risk Assessments must be regularly reviewed and updated. Timescale for action 10/05/06 10/11/06 10/11/06 10/05/06 2. 3. 4. YA42 YA42 YA42YA9 23(4)(d) 13(5)(6) 13(4) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA6 YA24 Good Practice Recommendations Review progress in developing accessible formats for people who use the service. Refurbish the kitchen area once subsidence dealt with. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 28 3. 4. YA24 YA35 Professionally clean the home’s carpets or consider replacement. Provide challenging behaviour and makaton training to all staff. 10 Tanners Walk DS0000008194.V290287.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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